New Malaria Prevention Modalities: Long-Acting Interventions Beyond Vaccines.

Malaria prevention is key for protecting high-risk groups, such as children and pregnant women. Existing approaches, including insecticide-based vector control, infant vaccination, and targeted chemoprevention are successful in some contexts. However, new tools are needed to broaden the scope and enhance the effectiveness of preventive strategies, particularly in high transmission areas. This paper examines emerging modalities for malaria chemoprevention beyond vaccination, illustrating advances toward long-acting interventions that can provide sustained protection with fewer doses. The pharmacological rationale and essential considerations for the clinical development and deployment of monoclonal antibodies, long-acting oral agents, and long-acting injectable small-molecule formulations are explored with examples. These innovations represent a step-change in malaria prevention, improving operational feasibility and long-term impact in endemic settings. They also have the potential to transform malaria prevention from a disease control tool in high-burden settings to a strategy capable of accelerating malaria elimination.